The effect on work presenteeism of job retention vocational rehabilitation compared to a written self-help work advice pack for employed people with inflammatory arthritis: protocol for a multi-centre randomised controlled trial (the WORKWELL trial).

Alison Hammond, Chris Sutton, Sarah Cotterill, Sarah Woodbridge, Rachel O’Brien, Kate Radford, Denise Forshaw, Suzanne Verstappen, Cheryl Jones, Antonia Marsden, Martin Eden, Yeliz Prior, June Culley, Paula Holland, Karen Walker-Bone, Yvonne Hough, Terence W. O’Neill, Angela Ching, Jennifer Parker

Research output: Contribution to journalArticlepeer-review

Abstract

Background
Work problems are common in people with inflammatory arthritis. Up to 50% stop work within 10 years due to their condition and up to 67% report presenteeism (i.e. reduced work productivity), even those with low disease activity. Job retention vocational rehabilitation (JRVR) may help prevent or postpone job loss and reduce presenteeism through work assessment, work-related rehabilitation and enabling job accommodations. This aims to create a better match between the person’s abilities and their job demands. The objectives of the Workwell trial are to test the overall effectiveness and cost-effectiveness of JRVR (WORKWELL) provided by additionally trained National Health Service (NHS) occupational therapists compared to a control group who receive self-help information both in addition to usual care.

Methods
Based on the learning from a feasibility trial (the WORK-IA trial: ISRCTN76777720), the WORKWELL trial is a multi-centre, pragmatic, individually-randomised parallel group superiority trial, including economic evaluation, contextual factors analysis and process evaluation. 240 employed adults with rheumatoid arthritis, undifferentiated inflammatory arthritis or psoriatic arthritis (in secondary care), aged 18 years or older with work instability will be randomised to one of two groups: a self-help written work
advice pack plus usual care (control intervention); or WORKWELL JRVR plus a selfhelp written work advice pack and usual care. WORKWELL will be delivered by
occupational therapists provided with additional JRVR training from the research team. The primary outcome is presenteeism as measured using the Work Limitations Questionnaire-25. A comprehensive range of secondary outcomes of work, health, contextual factors and health resource use are included. Outcomes are measured at 6- and 12- months (with 12-months as the primary end-point). A multi-perspective withintrial cost-effectiveness analyses will also be conducted.

Discussion
This trial will contribute to the evidence base for provision of JRVR to people with
inflammatory arthritis. If JRVR is found to be effective in enabling people to keep
working, the findings will support decision-making about provision of JRVR by
rheumatology teams, therapy services and healthcare commissioners, and providing evidence of the effectiveness of JRVR and the economic impact of its implementation.
Original languageEnglish
JournalBMC Musculoskeletal Disorders
Volume21
Issue number1
DOIs
Publication statusPublished - 10 Sept 2020

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